| NPI | 1235633751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: BCBA-1-19-35719) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106E00000X Assistant Behavior Analyst (Licence: BCBA-1-19-35719) | |
| 106S00000X Behavior Technician (Licence: CA RBT-16-20162) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2021-02-16 |