| NPI | 1154191633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: TX 23-296676) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2024-01-04 |
| Last Update Date | 2024-01-04 |