| NPI | 1033906250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: NM RBT-25-439244) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2025-04-22 |
| Last Update Date | 2025-05-29 |