| NPI | 1356047732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376J00000X Homemaker (Licence: 37600000X) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2023-03-13 |