| NPI | 1467349282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| Enumeration Date | 2025-06-23 |
| Last Update Date | 2025-06-23 |