| NPI | 1811436272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IN 1-20-46668) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IN 31006149A) |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2022-09-06 |