| NPI | 1720656622 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106S00000X Behavior Technician | 
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-25-16479) | 
| Enumeration Date | 2021-06-16 | 
| Last Update Date | 2025-09-21 |