| NPI | 1568154185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-23-274315) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL -23-274315) |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2023-05-23 |