| NPI | 1639500705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-13-14572) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-13-14572) |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2025-04-23 |