| NPI | 1760946263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL BCBA-1-25-83879) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2025-09-01 |