| NPI | 1891295754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-70890) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: 0-21-11927) |
| 106S00000X Behavior Technician (Licence: FL RBT-18-51938) | |
| Enumeration Date | 2018-02-17 |
| Last Update Date | 2024-03-05 |