| NPI | 1104623107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-24-380839) |
| Enumeration Date | 2025-02-26 |
| Last Update Date | 2025-06-18 |