| NPI | 1891300042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 5347) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: TX 3579) |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2022-09-14 |