| NPI | 1366133969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-26-88450) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2026-03-18 |