| NPI | 1780429209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| 106E00000X Assistant Behavior Analyst | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2024-06-26 |
| Last Update Date | 2024-06-26 |