| NPI | 1801498266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-25-81098) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 1862516) |
| Enumeration Date | 2020-11-11 |
| Last Update Date | 2025-05-06 |