| NPI | 1497268791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NV LBA0253) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CO 1-19-36091) |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2026-04-06 |