NPI | 1841834439 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MN 1-20-44426) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2019-11-06 |
Last Update Date | 2021-03-10 |