| NPI | 1043555196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-74771) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-14-5838) |
| Enumeration Date | 2012-11-30 |
| Last Update Date | 2025-03-01 |