| NPI | 1083404446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: PA BH006009) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: PA 1-22-58828) |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-09-16 |