| NPI | 1174124218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: CA E159907) |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2020-11-04 |