| NPI | 1013406800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: NV RBT-18-55106) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NV RBT0185) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2023-11-27 |