| NPI | 1437769023 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-74287) | 
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-128806) | 
| Enumeration Date | 2020-08-07 | 
| Last Update Date | 2024-07-30 |