| NPI | 1215749841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 372600000X Adult Companion |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2025-01-21 |
| Last Update Date | 2025-01-21 |