| NPI | 1649740218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 171400000X Health & Wellness Coach (Licence: CA 6CDCEB7C2E) |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2025-09-10 |