NPI | 1760259568 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL 25-415556) |
Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: WI 23379) |
Enumeration Date | 2023-12-11 |
Last Update Date | 2025-04-18 |