| NPI | 1952128613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2026-03-25 |