| NPI | 1275296527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: MT 9037) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: IN RBT-21-188666) |
| Enumeration Date | 2021-10-14 |
| Last Update Date | 2024-08-06 |