| NPI | 1528535861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IL 1-25-80253) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: IL RBT-18-68711) |
| Enumeration Date | 2018-10-24 |
| Last Update Date | 2025-04-08 |