| NPI | 1609348986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL Rbt-18-66659) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-12-26 |
| Last Update Date | 2019-01-03 |