| NPI | 1487230744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: MO RBT-21-163859) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA BACB301642) |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2021-04-22 |