| NPI | 1003478173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 1-25-82504) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106S00000X Behavior Technician (Licence: IN RBT-17-30491) | |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2025-07-09 |