| NPI | 1457204679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: WA RBT-26-524546) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: WA CBT.CB.70104247) |
| Enumeration Date | 2026-02-17 |
| Last Update Date | 2026-07-22 |