| NPI | 1063120236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: HI BA-961-0) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: HI RBT-19-95794) |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2025-08-15 |