| NPI | 1962153478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: GA RBT-22-199126) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: GA 1-25-79144) |
| Enumeration Date | 2022-01-16 |
| Last Update Date | 2025-02-07 |