NPI | 1982963104 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171W00000X Contractor |
Additional Taxonomies | 103K00000X Behavior Analyst |
171M00000X Case Manager/Care Coordinator | |
172A00000X Driver | |
Enumeration Date | 2012-05-08 |
Last Update Date | 2024-02-16 |