| NPI | 1962971556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-22-13861) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2023-07-24 |