| NPI | 1497261903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-23-65407) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-16-18490) |
| 106E00000X Assistant Behavior Analyst (Licence: CA 11341) | |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2025-11-25 |