| NPI | 1053925941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-122088) |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2025-01-22 |