| NPI | 1174082515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-24-77375) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-19-77026) |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2025-12-19 |