| NPI | 1982202909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: AZ RBT-19-107067) |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2022-12-05 |