NPI | 1518372358 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: MD 26134) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: PA BH001806) |
104100000X Social Worker (Licence: PA SW131370) | |
Enumeration Date | 2014-06-30 |
Last Update Date | 2023-02-03 |