| NPI | 1740840248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-20-137408) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-89686) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2020-10-05 |