| NPI | 1992211072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: CO 0-20-11436) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-74933) |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2021-08-10 |