| NPI | 1841975786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: CA PT37597) |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2025-03-27 |