| NPI | 1932828134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: TX RBT-22-230765) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2024-10-23 |