| NPI | 1215527072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT20138270) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: RBT-20-138270) |
| Enumeration Date | 2021-01-25 |
| Last Update Date | 2021-02-03 |