| NPI | 1790135036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 12152835) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-19-9852) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2024-07-30 |