| NPI | 1902403108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: KY 293335) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: KY RBT-20-116459) |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2024-09-04 |