| NPI | 1811884547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AR OT2025-019) |
| Enumeration Date | 2025-06-24 |
| Last Update Date | 2026-04-24 |