| NPI | 1699415208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-25-406164) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2025-01-20 |