| NPI | 1669106449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-23-67439) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-18-74076) |
| Enumeration Date | 2022-07-15 |
| Last Update Date | 2023-08-08 |