| NPI | 1649840323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 101Y00000X Counselor |
| 247200000X Technician, Other | |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2025-08-13 |