| NPI | 1558975300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-21-53406) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: CA 0-20-11667) |
| 106S00000X Behavior Technician (Licence: CA 00002434) | |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2022-10-13 |