| NPI | 1932506953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: MA S26882443) |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2026-06-24 |