| NPI | 1992586317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-23-294696) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: AZ RBT-23-294696) |
| Enumeration Date | 2023-10-11 |
| Last Update Date | 2026-06-03 |