| NPI | 1689150492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 101Y00000X Counselor |
| 106S00000X Behavior Technician | |
| 171400000X Health & Wellness Coach | |
| Enumeration Date | 2018-07-15 |
| Last Update Date | 2023-05-01 |