| NPI | 1174044085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 6301) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 001832) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2025-01-28 |