| NPI | 1740872605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-21-155302) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CO RBT-21-155302) |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2022-10-17 |