| NPI | 1194416099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: RBT-23-272562) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NV RBT3456) |
| Enumeration Date | 2023-05-19 |
| Last Update Date | 2023-12-28 |