| NPI | 1033797949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: RBT-20-118088) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ13399) |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2026-07-24 |