| NPI | 1548732035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-21-48868) |
| 106S00000X Behavior Technician (Licence: CA 17-30971) | |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2025-04-23 |