| NPI | 1467789081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN (Licence: 280706) |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2018-07-25 |