| NPI | 1992396576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 1-24-73218) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 106S00000X Behavior Technician (Licence: TX 1997546) | |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2024-06-20 |