| NPI | 1770082729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 106E00000X Assistant Behavior Analyst (Licence: FL 0-21-11715) | |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2022-01-06 |