| NPI | 1114631165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TN 1911) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-25-82289) |
| Enumeration Date | 2023-01-12 |
| Last Update Date | 2025-07-15 |