| NPI | 1588373757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AZ BEH-001460) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-22-62527) |
| Enumeration Date | 2022-11-16 |
| Last Update Date | 2025-02-23 |