| NPI | 1487163820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AZ BEH-000480) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: GA 1-17-27551) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2025-09-04 |