| NPI | 1366986804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NJ 1-16-24323) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NJ 15BC00219600) |
| Enumeration Date | 2016-12-16 |
| Last Update Date | 2025-07-12 |