| NPI | 1417658493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X |
| Additional Taxonomies | 225800000X Recreation Therapist |
| 372600000X Adult Companion | |
| 156F00000X Technician/Technologist | |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| Enumeration Date | 2023-03-15 |
| Last Update Date | 2023-03-20 |