| NPI | 1841766953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NM 1-23-65745) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2018-10-16 |
| Last Update Date | 2025-04-30 |