| NPI | 1841810785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-21-55342) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-19-74956) |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2024-04-16 |