| NPI | 1740846104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL BCBA-1-24-72704) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-05-11 |
| Last Update Date | 2024-04-29 |