| NPI | 1659098150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AR 1-25-82291) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: AR RBT-22-236903) |
| Enumeration Date | 2022-10-25 |
| Last Update Date | 2025-07-07 |