| NPI | 1184199853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 174400000X Specialist | |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2025-03-27 |