| NPI | 1386317600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-22-59501) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: TN BCaBA28) |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2022-09-20 |