| NPI | 1326432139 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-21-47646) | 
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-16-7251) | 
| 247200000X Technician, Other | |
| Enumeration Date | 2015-03-19 | 
| Last Update Date | 2025-03-11 |