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 | 2022-10-03 |