| NPI | 1932786357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 1-23-64458) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX RBT-21-8585-290069) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2023-04-25 |