| NPI | 1073023669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2017-10-09 |
| Last Update Date | 2024-12-18 |