| NPI | 1154113967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NV LBA1010) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NV 1-25-81260) |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2025-08-12 |