| NPI | 1275247991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL BCBA-1-25-79194) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-22-230182) |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2025-02-26 |