| NPI | 1538644232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AZ 1-23-64391) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-18-66514) |
| 106E00000X Assistant Behavior Analyst (Licence: AZ 0-23-14269) | |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2026-05-26 |