| NPI | 1134882905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-24-73759) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-20-113502) |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2024-06-24 |