| NPI | 1952816936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-20-11331) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-18-47924) |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2020-09-11 |