| NPI | 1215766803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-25-83149) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL BCaBA-024-15416) |
| Enumeration Date | 2024-07-31 |
| Last Update Date | 2025-08-07 |