| NPI | 1114686383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 46-1305562) |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2025-09-11 |