| NPI | 1508365370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-21-53763) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA D7435110) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2021-10-25 |