| NPI | 1730675752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OH 1-25-79094) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2025-02-04 |