| NPI | 1891292371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OK 1-20-44279) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2020-09-01 |