| NPI | 1548983588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: UT 870595270) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: UT 0595270) |
| Enumeration Date | 2022-09-23 |
| Last Update Date | 2022-09-23 |