| NPI | 1609658715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-24-15696) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2025-01-07 |