| NPI | 1194490540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: MD RB-21-193868) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2025-06-20 |