| NPI | 1043931298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-77092) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-22-232293) |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2024-12-16 |