| NPI | 1528572948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-20-44126) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2025-08-29 |