| NPI | 1063926046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-20-46046) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2020-11-19 |