| NPI | 1609446772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MD 1-25-80417) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: MD 0-21-11705) |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2025-08-15 |