| NPI | 1962074492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: NC 0-21-12768) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: NC A851) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2025-02-05 |