| NPI | 1427307651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA VN259729) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA VN259729) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2014-04-02 |