| NPI | 1215713573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: 0-26-16901) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-23-296064) |
| Enumeration Date | 2023-09-04 |
| Last Update Date | 2026-02-11 |