| NPI | 1417600628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: OH RBT-22-201192) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-22-201192) |
| Enumeration Date | 2022-01-28 |
| Last Update Date | 2022-07-13 |