| NPI | 1962168799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: TX RBT-21-193125) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX RBT21193125) |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2023-02-02 |