NPI | 1144871112 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-25-461991) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL PTA26880) |
Enumeration Date | 2019-09-21 |
Last Update Date | 2025-09-02 |