| NPI | 1346776606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL 1346776606) |
| Enumeration Date | 2017-05-05 |
| Last Update Date | 2021-11-10 |