| NPI | 1023468030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 251E00000X Home Health |
| 253Z00000X In Home Supportive Care | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2025-09-19 |