| NPI | 1528707924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-23-14352) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-83049) |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2023-03-04 |