| NPI | 1093423584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-25-16010) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-22-243636) |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2025-04-13 |