| NPI | 1043868391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: WA CG61128433) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2020-12-03 |