| NPI | 1477282614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: RI LBA00557) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA LABA10002295) |
| Enumeration Date | 2022-06-05 |
| Last Update Date | 2026-10-08 |