| NPI | 1861976979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: UT RBT-18-65983) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2018-09-25 |