| NPI | 1386189512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-18-58174) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2016-12-26 |
| Last Update Date | 2018-12-27 |