| NPI | 1851847172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: FL CNA-212196) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL RBT-16-12777) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-08-28 |