| NPI | 1841556321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NV LBAT042011) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2022-06-17 |