| NPI | 1497948418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 8986) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2024-01-05 |