| NPI | 1427651082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-26-89475) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-20-125715) |
| Enumeration Date | 2020-11-17 |
| Last Update Date | 2026-05-11 |