| NPI | 1386326536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-25-83557) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL 23-285425) |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2025-08-21 |