| NPI | 1366903841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-24-75437) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-18-71530) |
| 106E00000X Assistant Behavior Analyst (Licence: CA 0-21-12365) | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2025-01-22 |