| NPI | 1952973885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AR 1-25-83665) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2025-09-12 |