| NPI | 1750157566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X Health & Wellness Coach |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 172V00000X Community Health Worker | |
| 222Q00000X Developmental Therapist | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 103K00000X Behavior Analyst | |
| 104100000X Social Worker | |
| 106E00000X Assistant Behavior Analyst | |
| Enumeration Date | 2023-12-01 |
| Last Update Date | 2023-12-01 |