| NPI | 1245940402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NM 1-25-86565) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MD 1-25-86564) |
| Enumeration Date | 2022-11-29 |
| Last Update Date | 2026-07-22 |