| NPI | 1417500802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA 1980698) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA RBT-19-80698) |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2021-04-21 |