| NPI | 1912418385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA RBT-19-98229) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 00007102) |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2019-11-27 |