| NPI | 1841763422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TN 1-25-79013) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 106S00000X Behavior Technician (Licence: FL RBT-18-73414) | |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2025-03-26 |