| NPI | 1801564786 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103K00000X Behavior Analyst | 
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL BACB661625) | 
| Enumeration Date | 2021-09-03 | 
| Last Update Date | 2025-07-14 |