NPI | 1326803693 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 17439-I) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 2424) |
103K00000X Behavior Analyst | |
Enumeration Date | 2024-02-15 |
Last Update Date | 2025-09-12 |