| NPI | 1841789195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 32837) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2022-09-13 |