| NPI | 1306233226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IL 152.000310) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103K00000X Behavior Analyst (Licence: OH COBA.00483) | |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2026-04-28 |