| NPI | 1750678769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: IL BACB955401) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 207Q00000X Family Medicine (Licence: IL 125-059715) | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2023-07-12 |