NPI | 1609202985 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225400000X Rehabilitation Practitioner |
Additional Taxonomies | 103K00000X Behavior Analyst |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2013-09-18 |
Last Update Date | 2020-12-03 |