NPI | 1609207018 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106S00000X Behavior Technician (Licence: RBT-15-10491) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2013-12-10 |
Last Update Date | 2017-12-14 |