NPI | 1639712409 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
Additional Taxonomies | 103K00000X Behavior Analyst |
172V00000X Community Health Worker | |
175T00000X Peer Specialist | |
Enumeration Date | 2019-10-23 |
Last Update Date | 2025-06-02 |