| NPI | 1639793219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-24-72555) |
| Enumeration Date | 2020-05-30 |
| Last Update Date | 2024-11-21 |