| NPI | 1659916187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA RBT-21-160970) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2021-03-25 |