| NPI | 1770081580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-18-50214) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2019-06-20 |