| NPI | 1912408774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2021-01-12 |