| NPI | 1619368149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 146N00000X Emergency Medical Technician, Basic | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2015-02-05 |