| NPI | 1831707850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-21-54662) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ12569) |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2026-03-17 |