| NPI | 1467926584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 2084N0400X) |
| Enumeration Date | 2019-01-11 |
| Last Update Date | 2019-01-14 |