| NPI | 1316555964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-23-65685) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: AL 1-23-65685) |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2025-05-03 |