| NPI | 1740876564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: AZ RBT-20-143395) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-12-16 |
| Last Update Date | 2024-08-27 |