| NPI | 1912581166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 7401003190) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MI R550777067557) |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2026-02-04 |