| NPI | 1023771292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT21186179) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-21-186179) |
| Enumeration Date | 2021-10-14 |
| Last Update Date | 2022-06-03 |