| NPI | 1801307160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-71639) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL 19-82-801) |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2025-02-03 |