| NPI | 1295334332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-22-63217) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-129565) |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2023-01-04 |