| NPI | 1295405561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NE 0880) |
| 103K00000X Behavior Analyst (Licence: MO 2024025662) | |
| Enumeration Date | 2021-09-17 |
| Last Update Date | 2026-08-04 |