| NPI | 1063918597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-19-35670) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-18-48229) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2024-08-13 |