| NPI | 1043886930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: PA BH007312) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: BACB843445) |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2025-01-07 |