| NPI | 1609442326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 1-26-2828659) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 106E00000X Assistant Behavior Analyst (Licence: CO 17842) | |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2026-08-07 |