NPI | 1457814410 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: LA 010535976) |
Enumeration Date | 2019-04-08 |
Last Update Date | 2020-07-30 |