NPI | 1124644984 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 103K00000X Behavior Analyst |
Enumeration Date | 2020-06-17 |
Last Update Date | 2022-07-08 |