| NPI | 1194561506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IL 152.002895) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: BACB772152) |
| Enumeration Date | 2024-07-04 |
| Last Update Date | 2025-08-11 |