| NPI | 1891293411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: VA A61468992) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2018-01-29 |