| NPI | 1124766209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-25-79264) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: CA 0-22-13700) |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2025-07-09 |