| NPI | 1902419567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: UT 14190271-2506) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: UT RBT-20-120673) |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2024-11-03 |