| NPI | 1497114375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172A00000X Driver (Licence: VA t67507941) |
| Additional Taxonomies | 101Y00000X Counselor |
| 225600000X Dance Therapist | |
| 225C00000X Rehabilitation Counselor | |
| 373H00000X Day Training/Habilitation Specialist | |
| 374U00000X Home Health Aide | |
| 376G00000X Nursing Home Administrator | |
| 376J00000X Homemaker | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2016-02-19 |
| Last Update Date | 2020-09-02 |