| NPI | 1265880991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-19-35170) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL BCaBA0-18-8497) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2026-03-04 |