| NPI | 1871941492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL RBT-15-04600) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2021-08-13 |