| NPI | 1528625720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: AZ RBT-19-86189) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2025-09-16 |