| NPI | 1407144421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149019245) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2023-07-17 |