| NPI | 1053829523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133004745) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 103K00000X Behavior Analyst | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2025-11-15 |