| NPI | 1477337780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 251E00000X Home Health (Licence: MD RSA01475) |
| 374U00000X Home Health Aide (Licence: MD RSA-01475) | |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2024-05-30 |