NPI | 1710538749 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: CA 51569) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2019-09-20 |
Last Update Date | 2021-11-19 |