| NPI | 1538048095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: HI RBT-25-9987-1013633) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: HI EMT-3396) |
| Enumeration Date | 2025-08-28 |
| Last Update Date | 2025-08-28 |