NPI | 1003317306 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 103T00000X Psychologist |
106S00000X Behavior Technician | |
172V00000X Community Health Worker | |
Enumeration Date | 2018-02-22 |
Last Update Date | 2024-09-12 |