| NPI | 1093633778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA RBT-20-132795) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA BACB1069667) |
| Enumeration Date | 2026-07-09 |
| Last Update Date | 2026-07-17 |