| NPI | 1053829523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OH COBA.01970) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103K00000X Behavior Analyst (Licence: VA 0133004745) | |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2026-08-17 |