| NPI | 1225530223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-21-56405) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA RBT-17-39020) |
| 106S00000X Behavior Technician (Licence: CA RBT-17-39020) | |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2022-01-14 |