| NPI | 1861320186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 1041S0200X Social Worker, School | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2026-05-08 |
| Last Update Date | 2026-09-17 |