| NPI | 1326869538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 253Z00000X In Home Supportive Care | |
| 374700000X Technician | |
| Enumeration Date | 2024-10-21 |
| Last Update Date | 2024-10-21 |