| NPI | 1104439256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-25-86544) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-131768) |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2025-12-17 |