| NPI | 1619675956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: OR ABA-IN-10230483) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-02-16 |
| Last Update Date | 2023-03-06 |