| NPI | 1194608257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MI 99-2724721) |
| Enumeration Date | 2025-07-28 |
| Last Update Date | 2025-07-28 |