NPI | 1477148690 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-70598) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-21-151833) |
Enumeration Date | 2021-03-09 |
Last Update Date | 2024-01-09 |