| NPI | 1891438636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: RBT-21-155594) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2022-04-19 |