| NPI | 1184202186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-73737) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT21157604) |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2024-06-28 |