| NPI | 1538623145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 171400000X Health & Wellness Coach (Licence: CA 6F9F5E485D) | |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2026-06-30 |