| NPI | 1639762206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-23-64061) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: CA 11892) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2021-02-15 |
| Last Update Date | 2023-04-03 |