| NPI | 1548766942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-18-74151) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2023-04-06 |