| NPI | 1669908687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-26-2828367) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-21-13173) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2026-07-16 |