| NPI | 1730538778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: FL 0100037) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2024-11-11 |