| NPI | 1821634031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-22-59612) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: 0-21-11839) |
| 106S00000X Behavior Technician (Licence: RBT-19-98644) | |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2024-07-31 |