| NPI | 1790456267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: WA RBT-21-188169) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: WA CB61225357) |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2026-05-15 |