| NPI | 1699264879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW19849) |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2024-02-08 |