| NPI | 1629700984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: OR 201041505) |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2022-06-27 |