| NPI | 1457886665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-21-52819) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-77076) |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2024-08-06 |