| NPI | 1871187914 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: OH RBT-21-157500) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH C.2203775-TRNE) |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2022-01-10 |