| NPI | 1427455955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 101Y00000X Counselor |
| 103K00000X Behavior Analyst | |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2015-05-08 |