| NPI | 1366026437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: MD RBT-21-170068) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2022-09-07 |