| NPI | 1669173399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL RBT-23-260644) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-26-2843297) |
| Enumeration Date | 2023-03-10 |
| Last Update Date | 2026-08-28 |