| NPI | 1386450286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: MI H400465589432) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2024-12-05 |
| Last Update Date | 2024-12-05 |