NPI | 1346733581 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 118110) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2018-06-12 |
Last Update Date | 2023-10-10 |