| NPI | 1447148788 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT25448030) | 
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL BACB1335742) | 
| Enumeration Date | 2025-06-25 | 
| Last Update Date | 2025-06-26 |