| NPI | 1932876729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: KY 282987) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| 106S00000X Behavior Technician (Licence: KY RBT-21-160724) | |
| Enumeration Date | 2021-08-27 |
| Last Update Date | 2023-06-02 |