| NPI | 1306347976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-19-39483) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2023-01-09 |