| NPI | 1013472968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-25-84270) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: CA QASP-15736) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2025-09-23 |