| NPI | 1255060505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 372600000X Adult Companion | |
| 373H00000X Day Training/Habilitation Specialist | |
| 3747A0650X Technician, Attendant Care Provider | |
| 376J00000X Homemaker | |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2022-06-09 |