| NPI | 1629318639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL RBT-26-541080) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 688366121) |
| Enumeration Date | 2013-02-27 |
| Last Update Date | 2026-06-19 |