| NPI | 1659943181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-23-69460) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL BCaBA-0-23-14407) |
| 106S00000X Behavior Technician (Licence: FL RBT-21-159459) | |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2023-12-18 |