| NPI | 1679930606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-15-10829) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2022-07-21 |