| NPI | 1578156428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA RBT-18-61514) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-18-61514) |
| Enumeration Date | 2021-02-11 |
| Last Update Date | 2021-02-11 |