| NPI | 1831873983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: TN RBT-23-282526) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-06-09 |
| Last Update Date | 2023-08-29 |