| NPI | 1700378379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-21-48654) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA BCBA417447) |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2021-04-02 |