| NPI | 1346830189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-20-118658) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL 118658) |
| Enumeration Date | 2021-01-26 |
| Last Update Date | 2022-03-25 |