| NPI | 1891338810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 1-22-59750) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2022-07-06 |