| NPI | 1447807698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-23-70170) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2024-01-10 |