| NPI | 1205312782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA F7303898) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-07-17 |