| NPI | 1407580574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: UT F25-117172) |
| Enumeration Date | 2022-07-13 |
| Last Update Date | 2026-09-14 |