| NPI | 1851078778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 251B00000X Case Management |
| 106E00000X Assistant Behavior Analyst | |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2025-11-09 |