| NPI | 1083118707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-21-57337) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA RBT-17-38920) |
| 106S00000X Behavior Technician (Licence: CA RBT-17-38920) | |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2022-01-07 |