| NPI | 1588454573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL RBT-25-429615) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-05-12 |