| NPI | 1649845116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: VA RBT-18-52170) |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2021-05-26 |