| NPI | 1659057594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-25-16234) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-23-280947) |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2025-09-25 |