| NPI | 1700359015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL BCaBA0188751) |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2022-02-04 |