| NPI | 1699173898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: PR 19248) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 103K00000X Behavior Analyst (Licence: 19248) | |
| Enumeration Date | 2014-12-21 |
| Last Update Date | 2023-12-26 |