| NPI | 1740838143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NV 1-25-79043) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: NV 0-23-14278) |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2025-01-29 |