| NPI | 1326937970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 385H00000X Respite Care |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2025-06-30 |
| Last Update Date | 2025-06-30 |