NPI | 1639733975 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106S00000X Behavior Technician |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-04-23 |
Last Update Date | 2021-09-13 |