| NPI | 1750974127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: NC RBT-21-156028) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-02-17 |
| Last Update Date | 2021-09-23 |