| NPI | 1720681273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-73620) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-2314716) |
| 106S00000X Behavior Technician (Licence: FL RBT-20-145104) | |
| Enumeration Date | 2020-11-18 |
| Last Update Date | 2024-12-02 |