| NPI | 1508637885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-26-88202) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-25-15944) |
| 106S00000X Behavior Technician (Licence: FL RBT-24-320571) | |
| Enumeration Date | 2024-01-15 |
| Last Update Date | 2026-03-06 |