| NPI | 1073219861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: NE 23-256503) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-02-02 |
| Last Update Date | 2025-05-27 |