| NPI | 1649787003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-20-45092) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-17-33563) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2020-10-14 |