| NPI | 1235609173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-21-55373) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: UT RBT-18-69002) |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2023-04-19 |