| NPI | 1366117699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: TN RBT-19-95230) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-08-10 |
| Last Update Date | 2021-08-10 |