| NPI | 1245732627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA RBT-22-200513) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2022-02-24 |