| NPI | 1386303899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-21-48872) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 004219) |
| 103K00000X Behavior Analyst (Licence: CT 1184) | |
| Enumeration Date | 2021-12-12 |
| Last Update Date | 2026-03-22 |