| NPI | 1437628658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-25-86730) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-18-55600) |
| 106E00000X Assistant Behavior Analyst (Licence: FL 0-22-13633) | |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2025-12-23 |