| NPI | 1639496326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 106366) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 1-14-10382) |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2024-01-29 |