| NPI | 1992471403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: CA 6094) |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2022-08-09 |