| NPI | 1629436175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 247200000X Technician, Other |
| 247200000X Technician, Other | |
| Enumeration Date | 2016-01-29 |
| Last Update Date | 2025-05-15 |