| NPI | 1801386933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 7401001933) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MI RBT-17-30177) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2026-02-23 |