| NPI | 1194361162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 85-4482700) |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2023-06-27 |