| NPI | 1376179739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-25-83945) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 106E00000X Assistant Behavior Analyst (Licence: FL 0-23-14861) | |
| Enumeration Date | 2020-03-18 |
| Last Update Date | 2026-08-03 |