| NPI | 1528430311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: RI LBA00006) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: RI 1-15-21233) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2025-08-25 |