| NPI | 1881207512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 11755-C) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NV 11755-C) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2024-10-01 |