| NPI | 1861220501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2471N0900X Radiologic Technologist, Nuclear Medicine Technology | |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2024-07-25 |