| NPI | 1316674724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| 171M00000X Case Manager/Care Coordinator | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2022-08-04 |
| Last Update Date | 2022-12-26 |