| NPI | 1558984419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: GA RBT-20-135032) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2023-04-06 |