| NPI | 1700502549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX rbt-22-224503) |
| Enumeration Date | 2022-10-13 |
| Last Update Date | 2025-02-27 |