| NPI | 1538605944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-19-35343) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA E1349108) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2022-08-08 |