| NPI | 1922630938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-21-47250) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2023-04-10 |