| NPI | 1265050611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-22-212028) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-123054) |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2022-06-13 |