| NPI | 1053968446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL BCBA-1-24-76665) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-95076) |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2024-10-18 |