| NPI | 1932688181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-23-67502) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-18-62157) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2023-08-21 |