| NPI | 1679052047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-18-60664) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2022-07-21 |