| NPI | 1265322325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: WA CB61494567) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2025-07-08 |
| Last Update Date | 2025-07-08 |