| NPI | 1821786922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-2583652) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: 0-25-15880) |
| 106S00000X Behavior Technician (Licence: RBT-23-270675) | |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2026-03-27 |