| NPI | 1326615071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 376J00000X Homemaker |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2022-06-16 |