| NPI | 1619599917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: BCBA1-25-85914) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: GA LBA002797) |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2026-05-27 |