| NPI | 1760039960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WA BA61484265) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 04233) |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2025-06-04 |