| NPI | 1285363994 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103K00000X Behavior Analyst | 
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) | 
| 103TC1900X Psychologist, Counseling | |
| 106E00000X Assistant Behavior Analyst | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2022-06-08 | 
| Last Update Date | 2022-06-08 |