| NPI | 1437995289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: PA BH007423) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: VA 0133003765) |
| Enumeration Date | 2024-07-02 |
| Last Update Date | 2025-09-16 |