| NPI | 1669277117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IN 1-25-81734) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: IN RBT-21-194934) |
| Enumeration Date | 2025-02-18 |
| Last Update Date | 2025-08-15 |