| NPI | 1285226894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-24-71246) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-20-127254) |
| Enumeration Date | 2021-02-04 |
| Last Update Date | 2024-02-22 |