| NPI | 1215518873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AZ BEH-001417) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-24-75864) |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2025-02-10 |