| NPI | 1275033748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-20-43833) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-17-44014) |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2021-08-03 |