| NPI | 1215495072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT19105792) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2019-11-11 |