| NPI | 1336780188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-24-72311) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA F5766405) |
| 106S00000X Behavior Technician (Licence: CA 15150) | |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2025-12-01 |