| NPI | 1225329469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-21-56289) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2023-03-15 |