| NPI | 1992011357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-02-0969) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: AZ BEH-001339) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2026-08-11 |