| NPI | 1609036607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: FL SW19604) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: SW19604) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2024-09-26 |