| NPI | 1558722116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 351041) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106S00000X Behavior Technician (Licence: FL RBT-17-38021) | |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2020-12-10 |