| NPI | 1508322108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 2255R0406X Specialist/Technologist, Rehabilitation, Blind | |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2020-01-09 |