| NPI | 1669992574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor |
| 227800000X Respiratory Therapist, Certified | |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2024-01-02 |