| NPI | 1023563657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: UT 12844646-2507) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2022-05-12 |