| NPI | 1851954739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-25-15950) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2025-04-26 |