| NPI | 1619413028 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NE 0342) | 
| Additional Taxonomies | 103K00000X Behavior Analyst | 
| 103K00000X Behavior Analyst (Licence: UT 10673486-2506) | |
| 106E00000X Assistant Behavior Analyst | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-01-09 | 
| Last Update Date | 2025-07-10 |