| NPI | 1922508126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA RBT-15-02199) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 00001217) |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2020-12-08 |