| NPI | 1043731177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-22-14167) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL C234-721-92-172-0) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2023-05-18 |