| NPI | 1134739170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-23-70309) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-130191) |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2023-12-21 |