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 |