| NPI | 1487019931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NY 1-21-47345) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2023-04-26 |