| NPI | 1629809983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL M614-160-05-267-0) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2024-11-21 |