NPI | 1063119337 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist |
Additional Taxonomies | 103K00000X Behavior Analyst |
106S00000X Behavior Technician | |
172V00000X Community Health Worker | |
3747P1801X Technician, Personal Care Attendant | |
Enumeration Date | 2023-02-07 |
Last Update Date | 2025-08-26 |