| NPI | 1467112441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-25-82255) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-24-14970) |
| 106S00000X Behavior Technician | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2021-12-18 |
| Last Update Date | 2025-09-24 |