| NPI | 1679071419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-20-43404) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-16-18272) |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2020-11-06 |