| NPI | 1932978681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-26-2843494) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-23-314689) |
| Enumeration Date | 2023-12-21 |
| Last Update Date | 2026-08-25 |