| NPI | 1336635556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 146D00000X Personal Emergency Response Attendant | |
| 171M00000X Case Manager/Care Coordinator | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2024-08-01 |