| NPI | 1760955884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-75256) |
| Enumeration Date | 2019-01-11 |
| Last Update Date | 2021-02-03 |