| NPI | 1063129252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 0-25-16454) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-25-16454) |
| 106S00000X Behavior Technician (Licence: FL RBT-22-237084) | |
| Enumeration Date | 2022-10-28 |
| Last Update Date | 2026-05-08 |