| NPI | 1174125629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 0-24-15479) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-142924) |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2024-09-11 |