| NPI | 1750145397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: WI 25-337) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-24-323129) |
| Enumeration Date | 2024-02-13 |
| Last Update Date | 2025-08-29 |