| NPI | 1326428756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-21-53700) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-18-9350) |
| 106S00000X Behavior Technician (Licence: FL RBT-23-257740) | |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2023-04-27 |