| NPI | 1912408634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA RBT-17-28653) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2018-10-16 |