NPI | 1811451230 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225400000X Rehabilitation Practitioner |
Additional Taxonomies | 172V00000X Community Health Worker |
373H00000X Day Training/Habilitation Specialist | |
Enumeration Date | 2019-01-30 |
Last Update Date | 2025-06-24 |