| NPI | 1992379051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CA RBT-21-165588) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2021-05-13 |