| NPI | 1467807404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 372600000X Adult Companion | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2017-11-03 |