| NPI | 1346990801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: VA RBT-22-209372) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: VA 22-209372) |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2022-03-28 |