| NPI | 1528532637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: HI BA-384) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-19-40001) |
| 103K00000X Behavior Analyst (Licence: BA-384) | |
| Enumeration Date | 2019-01-11 |
| Last Update Date | 2025-07-21 |