| NPI | 1295327146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: CA MPSS-JKYHOE) |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2025-08-25 |