| NPI | 1558915249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-23-67646) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 106S00000X Behavior Technician (Licence: CA E1335999) | |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2023-09-12 |