| NPI | 1558024612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-133148) |
| Enumeration Date | 2021-10-15 |
| Last Update Date | 2024-02-16 |