| NPI | 1649988981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0134000561) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| 106S00000X Behavior Technician (Licence: VA RBT-22-218139) | |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2025-03-05 |