| NPI | 1679201701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA 22-249556) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-08-08 |
| Last Update Date | 2024-01-25 |