| NPI | 1922683408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 3705) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-21-49968) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2021-03-16 |
| Last Update Date | 2026-04-21 |