| NPI | 1053851097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-21-12227) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL 1-04-1699) |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2021-07-06 |