| NPI | 1295237147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-21-55596) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA BCAT00002520) |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2021-12-16 |