| NPI | 1265040679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 374U00000X Home Health Aide |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2023-08-08 |