| NPI | 1891159588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: 0-17-8156) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: FL C500-113-91-251-0) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2018-03-17 |