| NPI | 1043610785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL BCBA-19-37425) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| Enumeration Date | 2014-08-31 |
| Last Update Date | 2023-01-26 |