| NPI | 1760057285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: AL 2024-078) |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2025-05-22 |