| NPI | 1073012191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL BCaBA-0-26-16810) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-02-04 |
| Last Update Date | 2026-02-03 |