| NPI | 1386101053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-25-82975) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-18-47106) |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2026-01-09 |