| NPI | 1972198075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 1-25-82567) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CO RBT-21-157979) |
| Enumeration Date | 2021-03-02 |
| Last Update Date | 2025-07-23 |