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 |