| NPI | 1346823630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-25-874138) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-25-15823) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2025-09-16 |