| NPI | 1609115369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-12-12387) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: PA BH000158) |
| 103K00000X Behavior Analyst (Licence: MD LBA972) | |
| 103K00000X Behavior Analyst (Licence: VA 0133000226) | |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2013-01-31 |
| Last Update Date | 2025-07-07 |