| NPI | 1174347520 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: KS RBT-24-381608) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2024-11-12 |
| Last Update Date | 2024-11-12 |