| NPI | 1174346811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| Enumeration Date | 2024-11-01 |
| Last Update Date | 2024-11-11 |