NPI | 1043658693 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: NV 01142-INTERN) |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2013-06-05 |
Last Update Date | 2014-06-27 |