| NPI | 1134745466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-117946) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2022-01-27 |