| NPI | 1104663715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 372500000X Chore Provider | |
| 372600000X Adult Companion | |
| Enumeration Date | 2024-07-10 |
| Last Update Date | 2024-07-10 |