| NPI | 1740769389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NJ 15BC00141100) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NJ RBT-18-62722) |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2025-06-17 |