| NPI | 1003427345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA RBT-19-101633) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-23-65286) |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2025-08-07 |