| NPI | 1336852698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: AL RBT-22-250369) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: AL RBT22-250369) |
| Enumeration Date | 2023-01-03 |
| Last Update Date | 2023-01-03 |