NPI | 1831621523 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: UT 12375668-2506) |
Additional Taxonomies | 172V00000X Community Health Worker |
106S00000X Behavior Technician | |
Enumeration Date | 2017-03-31 |
Last Update Date | 2022-03-30 |