| NPI | 1801677323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-23-301700) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL R362000000921) |
| Enumeration Date | 2023-10-10 |
| Last Update Date | 2023-10-10 |