NPI | 1346889318 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA 42287) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2019-12-23 |
Last Update Date | 2022-08-04 |