| NPI | 1598267791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-22-58947) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA BACB382766) |
| Enumeration Date | 2018-03-03 |
| Last Update Date | 2022-05-09 |