| NPI | 1184216616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-23-69995) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-21-161319) |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2024-01-17 |