| NPI | 1821144700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL MH8153) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: FL MH 8153) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2025-03-13 |