| NPI | 1386149862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-21-47351) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: UT 14220191-2506) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2025-06-10 |