| NPI | 1891188744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133002119) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: IL 1-14-17655) |
| 103K00000X Behavior Analyst (Licence: MD LBA1597) | |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2026-06-18 |