| NPI | 1497345524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-24-71914) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-21-152548) |
| Enumeration Date | 2021-01-22 |
| Last Update Date | 2024-03-19 |