| NPI | 1134617566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-18-53374) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT18-53374) |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2018-06-16 |