| NPI | 1528528759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-19-34512) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2019-04-29 |