| NPI | 1376960369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 1-14-15392) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103K00000X Behavior Analyst (Licence: AZ BEH-001624) | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2025-01-31 |