| NPI | 1043540594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist (Licence: OK 320178900107) |
| Additional Taxonomies | 376J00000X Homemaker (Licence: OK 37V840760399) |
| 376K00000X Nurse's Aide (Licence: OK 37V615640107) | |
| 372500000X Chore Provider (Licence: OK 37V840760399) | |
| 372600000X Adult Companion (Licence: OK 37V840760399) | |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2010-01-06 |