| NPI | 1427643782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133003609) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 106E00000X Assistant Behavior Analyst (Licence: MI 7402000170) | |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2025-07-09 |