| NPI | 1801633276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: NV RBT4391) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NV RBT-24-360145) |
| Enumeration Date | 2024-07-11 |
| Last Update Date | 2025-08-15 |