| NPI | 1043028426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL BACB1026297) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-24-366592) |
| Enumeration Date | 2024-12-18 |
| Last Update Date | 2024-12-18 |