| NPI | 1871051607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-21-49290) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-19-79021) |
| 106E00000X Assistant Behavior Analyst (Licence: 0-19-10467) | |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2022-12-22 |