| NPI | 1578157194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-22-59530) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 00013111) |
| Enumeration Date | 2021-02-24 |
| Last Update Date | 2026-07-23 |