| NPI | 1235635319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-20-46163) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: GA LBA002852) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2026-07-04 |