| NPI | 1164920518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: CA 0-18-8515) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-16-17035) |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2022-10-12 |