| NPI | 1972210607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-25-15915) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-11-02 |
| Last Update Date | 2025-03-25 |