| NPI | 1710863683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| 106E00000X Assistant Behavior Analyst | |
| Enumeration Date | 2025-08-14 |
| Last Update Date | 2025-12-01 |