| NPI | 1386261576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-20-123063) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL RBT-20-123063) |
| Enumeration Date | 2020-07-03 |
| Last Update Date | 2020-07-23 |