| NPI | 1861043887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-22-61715) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-22-617715) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2022-12-06 |