| NPI | 1023496379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 372600000X Adult Companion |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: CA Aii8911214) |
| 247200000X Technician, Other (Licence: CA Aii7891214) | |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2025-05-22 |