| NPI | 1730968645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: CA 0-26-16801) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-22-249545) |
| Enumeration Date | 2023-09-28 |
| Last Update Date | 2026-05-11 |