| NPI | 1699329466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL BCBA1-26-2827662) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-18-64037) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2026-07-07 |