| NPI | 1245924059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TN 1-21-47137) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: AL LBA1551) |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2025-08-19 |