| NPI | 1255035788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-24-72003) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-22-236186) |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2024-04-01 |