| NPI | 1912318015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-13-14196) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: AZ BEH-000377) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2026-05-20 |