| NPI | 1992410260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-74743) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-23-252193) |
| Enumeration Date | 2023-01-20 |
| Last Update Date | 2024-08-11 |