| NPI | 1235722422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 1686) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NC 3249) |
| Enumeration Date | 2021-02-18 |
| Last Update Date | 2025-08-19 |