| NPI | 1649859661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 8396) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX Rbt-21-162668) |
| 106E00000X Assistant Behavior Analyst (Licence: TX 8009) | |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2026-06-17 |