| NPI | 1023648466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX RBT-19-94755) |
| Enumeration Date | 2020-01-24 |
| Last Update Date | 2026-06-10 |