| NPI | 1023508785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL BCBA-1-25-81978) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-25-81978) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2025-08-07 |