| NPI | 1124757174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA RBT-26-513573) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2026-02-18 |