| NPI | 1073212940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-26-17017) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CO 22-240374) |
| Enumeration Date | 2023-02-28 |
| Last Update Date | 2026-03-29 |