| NPI | 1659142859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 45) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 4254) |
| Enumeration Date | 2024-01-16 |
| Last Update Date | 2024-01-16 |