| NPI | 1528653664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: LA R-8252) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-21-155534) |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2021-03-01 |