| NPI | 1558948935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-22-59155) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2022-04-27 |