| NPI | 1477112746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-23-65981) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL 1869639) |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2025-04-24 |