NPI | 1205293396 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: MO 2017037743) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2016-01-21 |
Last Update Date | 2017-12-28 |