| NPI | 1649159633 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IN 1-25-85463) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: IN RBT-21-194435) |
| Enumeration Date | 2025-09-02 |
| Last Update Date | 2025-11-10 |