| NPI | 1750069050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-25-86825) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-23-281757) |
| Enumeration Date | 2023-07-06 |
| Last Update Date | 2026-01-09 |