| NPI | 1033536065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant (Licence: TX 006749) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: TX 0006749) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2014-03-27 |