| NPI | 1427568252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-18-30157) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: CA 0-17-8073) |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2024-05-24 |