| NPI | 1861924649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-17-27129) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: CA 0-16-7012) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2018-09-21 |