NPI | 1538702857 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2019-10-18 |
Last Update Date | 2022-07-21 |