| NPI | 1023678505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-21-11916) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-88792) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2021-05-12 |