| NPI | 1710545538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-23-68922) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-88826) |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2024-02-06 |