| NPI | 1851813794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ11827) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2024-01-23 |