| NPI | 1699406728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-73801) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NC 2315) |
| Enumeration Date | 2022-06-20 |
| Last Update Date | 2025-09-05 |