| NPI | 1437388410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 376J00000X Homemaker |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2025-12-16 |