| NPI | 1740868884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC 000033228751) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2024-10-29 |