| NPI | 1992327340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL BCBA-01-2687990) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-2011967) |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2026-03-02 |