| NPI | 1407608201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-24-346284) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2024-04-04 |
| Last Update Date | 2024-08-17 |