| NPI | 1326235045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 104100000X Social Worker |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2024-11-29 |