| NPI | 1477285591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 1-24-75130) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-24-75130) |
| 106S00000X Behavior Technician (Licence: NC RBT-21-169966) | |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2025-10-14 |