| NPI | 1821634890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-78480) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| 106S00000X Behavior Technician (Licence: RBT-19-85517) | |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2025-01-07 |