| NPI | 1326401159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 11621750) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CO 11621750) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2025-04-16 |