| NPI | 1043152895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA 196S00000X) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 103K00000X) |
| Enumeration Date | 2026-04-08 |
| Last Update Date | 2026-04-08 |