| NPI | 1174332084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3104A0630X Assisted Living Facility Assisted Living, Behavioral Disturbances (Licence: OH 652326-DD00296558) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: OH 652326-DD00296558) |
| 208VP0000X Pain Medicine Pain Medicine (Licence: OH 652326-DD00296558) | |
| 251J00000X Nursing Care (Licence: OH 652326-DD00296558) | |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2025-01-06 |