| NPI | 1124828355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MI RBT-25-441717) |
| Enumeration Date | 2025-03-17 |
| Last Update Date | 2025-08-03 |