| NPI | 1609342344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-22-62965) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-18-67467) |
| Enumeration Date | 2018-10-20 |
| Last Update Date | 2026-06-28 |