| NPI | 1396255832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 1-17-27608) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: IL 1-17-27608) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2026-03-27 |