| NPI | 1013524628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 372600000X Adult Companion | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2020-10-13 |