| NPI | 1093271850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-18-68721) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2025-08-13 |