| NPI | 1316544299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-26-2836699) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL M634431941440) |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2026-08-14 |