| NPI | 1144944497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL 22-234243) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-22-234243) |
| Enumeration Date | 2022-09-30 |
| Last Update Date | 2023-07-07 |