| NPI | 1871037895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 1-22-63268) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CO RBT-22-231477) |
| Enumeration Date | 2016-12-09 |
| Last Update Date | 2023-03-01 |