| NPI | 1700377421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: CA F7555179) |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2025-12-01 |