| NPI | 1821873803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-25-86214) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-23-285552) |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2025-12-19 |