| NPI | 1154926913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 174H00000X Health Educator |
| 101YP1600X Counselor, Pastoral | |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2024-04-10 |