| NPI | 1932841319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: RBT-21-185940) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: AZ RBT-21-185940) |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2022-04-07 |