| NPI | 1477444735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: VA A61672242) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 247200000X Technician, Other | |
| Enumeration Date | 2025-07-14 |
| Last Update Date | 2025-08-15 |