| NPI | 1760130306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 4432) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-24-75548) |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2026-06-10 |