| NPI | 1134367865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: HI RBT-21-181024) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: HI 106S00000X) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2023-06-08 |