| NPI | 1255929352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-23-67799) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: AZ 1-23-67799) |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2026-06-17 |