| NPI | 1871200832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-24-76346) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 106S00000X Behavior Technician (Licence: CA RBT-19-107041) | |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2024-11-20 |