| NPI | 1265882054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL RBT-16-21013) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2016-12-29 |