| NPI | 1568190429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 172A00000X Driver | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2022-08-09 |
| Last Update Date | 2022-12-06 |