| NPI | 1578254181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: HI RBT-23-281526) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2023-10-23 |