| NPI | 1942937453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: PA BH006333) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: PA RBT-20-118982) |
| Enumeration Date | 2022-08-04 |
| Last Update Date | 2023-03-27 |