| NPI | 1891349908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-22-60127) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-18-71496) |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2023-05-29 |