| NPI | 1255003976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: VA 01340000618) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: VA RBT-21-185534) |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2025-06-17 |