NPI | 1366903841 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: CA 0-21-12365) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-18-71530) |
Enumeration Date | 2019-03-27 |
Last Update Date | 2021-07-12 |