| NPI | 1699402073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 9097) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-21-173276) |
| Enumeration Date | 2022-08-04 |
| Last Update Date | 2025-10-16 |