| NPI | 1538047931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NJ 103K00000X) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 103K00000X) |
| Enumeration Date | 2025-08-25 |
| Last Update Date | 2025-08-25 |