| NPI | 1174154470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-20-11567) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT1998460) |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2026-02-12 |