| NPI | 1861754079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1084624) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-084624) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2025-06-17 |