NPI | 1952163727 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-24-76083) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2024-01-26 |
Last Update Date | 2025-05-19 |