NPI | 1962904847 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2018-03-06 |
Last Update Date | 2022-03-30 |