| NPI | 1376032763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-20-42600) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2024-06-18 |