| NPI | 1073859724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: CA SP16034) |
| Enumeration Date | 2012-12-28 |
| Last Update Date | 2022-05-19 |