| NPI | 1508002452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: CA d4084090) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2008-12-24 |
| Last Update Date | 2019-04-03 |