| NPI | 1659814531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2023-03-28 |