| NPI | 1427398783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-11-8443) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MD LBA214) |
| Enumeration Date | 2013-02-25 |
| Last Update Date | 2025-08-06 |