| NPI | 1265059125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA 20-136243) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2021-08-03 |