| NPI | 1053796433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: KS LBA00958) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-15-18287) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2026-02-24 |