| NPI | 1548700768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-18-61404) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2022-05-14 |