| NPI | 1851087225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-26-88092) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-22-250739) |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2026-05-19 |