| NPI | 1699139154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NV RBT-15-10967) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2018-02-05 |