NPI | 1457926362 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-25-80012) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-21-174278) |
Enumeration Date | 2021-05-24 |
Last Update Date | 2025-03-25 |