| NPI | 1962070151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 1-23-67319) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2023-11-17 |