| NPI | 1841936713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-25-83856) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-22-232020) |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2025-10-06 |