| NPI | 1992273460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-22-60128) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-18-61380) |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2022-07-20 |