| NPI | 1982270468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133002982) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: VA RBT-20-133007) |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2025-04-08 |