| NPI | 1790394856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 247200000X Technician, Other | |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2026-06-01 |