| NPI | 1508541087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: RI LBA00477) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA LABA10000305) |
| Enumeration Date | 2023-06-21 |
| Last Update Date | 2025-05-06 |