| NPI | 1679262752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: MD MT0155795) |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2024-09-13 |