| NPI | 1124694583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 1-22-60550) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NC RBT-19-82086) |
| Enumeration Date | 2021-05-27 |
| Last Update Date | 2026-03-10 |