| NPI | 1659188308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-25-423777) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2024-12-16 |
| Last Update Date | 2025-07-04 |