NPI | 1730740721 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 09990) |
Additional Taxonomies | 222Z00000X (Licence: MD 09990) |
106S00000X Behavior Technician (Licence: RBT-18-59876) | |
Enumeration Date | 2019-06-21 |
Last Update Date | 2025-07-24 |