| NPI | 1457713562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-22-59383) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 0-16-6975) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2022-05-23 |