| NPI | 1033686225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2018-10-26 |
| Last Update Date | 2024-11-06 |