| NPI | 1982206033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: CO 0-22-13926) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CO RBT-20-144415) |
| Enumeration Date | 2020-11-13 |
| Last Update Date | 2022-10-20 |