| NPI | 1386189512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-26-90099) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| 106S00000X Behavior Technician (Licence: FL RBT-18-58174) | |
| Enumeration Date | 2016-12-26 |
| Last Update Date | 2026-05-21 |