| NPI | 1285398875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-71828) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-126132) |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2024-03-28 |