| NPI | 1447582044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 1-14-15432) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 105010) |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2019-09-27 |