| NPI | 1689704405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC37962) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2018-06-05 |