| NPI | 1316522121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-25-81694) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: 23-255890) |
| Enumeration Date | 2021-03-12 |
| Last Update Date | 2025-06-09 |