| NPI | 1326406752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: HI 1-16-24885) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: HI RBT-16-14610) |
| Enumeration Date | 2016-01-30 |
| Last Update Date | 2025-01-27 |