| NPI | 1881356533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OH 1-24-71198) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OH RBT-21-174700) |
| Enumeration Date | 2021-10-11 |
| Last Update Date | 2024-03-15 |