| NPI | 1184070294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 24613) |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2025-11-22 |