| NPI | 1396356721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-20-118886) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-11-03 |