| NPI | 1366908220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 171M00000X Case Manager/Care Coordinator | |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| 372500000X Chore Provider | |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2019-02-15 |