| NPI | 1558805069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL BCBA-1-26-90845) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL BCaBA-0-21-13217) |
| Enumeration Date | 2016-12-19 |
| Last Update Date | 2026-07-24 |