| NPI | 1144839663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 12580051) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX BHV-010709) |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2026-07-27 |