| NPI | 1780141630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-21-55996) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-16-4282-36534) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2022-01-26 |