| NPI | 1790253680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-23-69501) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-18-68371) |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2023-11-29 |