| NPI | 1518323484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-22-61917) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-16-16330) |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2022-10-12 |