| NPI | 1356170203 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: MI 1-21-48482) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2024-07-30 |
| Last Update Date | 2025-06-23 |