| NPI | 1659992782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-22-59452) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: CA 0-21-12087) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2025-01-24 |