| NPI | 1700487568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-20-119677) |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2024-09-11 |