| NPI | 1083113971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CO 18-50607) |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2026-02-16 |