| NPI | 1285471508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 1-24-78484) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: TX 0-24-15337) |
| Enumeration Date | 2024-07-12 |
| Last Update Date | 2025-05-09 |