| NPI | 1508556911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-25-78938) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-23-268574) |
| Enumeration Date | 2023-05-09 |
| Last Update Date | 2025-01-28 |