| NPI | 1316688922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-22-58506) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 1-22-58506) |
| 103K00000X Behavior Analyst (Licence: NJ 1-22-58506) | |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2026-06-04 |