| NPI | 1003475468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-21-55382) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-20-10854) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2022-06-02 |