| NPI | 1609575356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 2355S0801X Specialist/Technologist, Speech-Language Assistant |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2023-03-01 |
| Last Update Date | 2025-03-11 |