| NPI | 1851883607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-20-46292) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NV RBT-17-35474) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2022-05-04 |