| NPI | 1912778093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: MD RBT-24-335602) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2024-01-09 |
| Last Update Date | 2026-01-06 |