| NPI | 1962990978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: CO 12254) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2026-05-07 |