| NPI | 1306358379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-78489) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2025-01-10 |