| NPI | 1417555376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-20-125706) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 20125706) |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2021-09-20 |