| NPI | 1396362257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-21-53342) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-125841) |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2022-04-19 |