| NPI | 1902408354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 1-21-48766) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MI RBT-19-105392) |
| Enumeration Date | 2020-11-11 |
| Last Update Date | 2024-12-11 |