| NPI | 1972188670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 2415336) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-03-14 |
| Last Update Date | 2025-01-30 |