NPI | 1942517453 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 103K00000X Behavior Analyst |
103TR0400X Psychologist Rehabilitation | |
Enumeration Date | 2010-09-03 |
Last Update Date | 2010-09-03 |