| NPI | 1972219277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NV 11423-m) |
| Additional Taxonomies | 104100000X Social Worker |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2023-01-30 |
| Last Update Date | 2024-10-09 |