| NPI | 1013735000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: WA RBT-24-380581) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: WA CB61601023) |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2026-05-19 |