| NPI | 1538510292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 372600000X Adult Companion |
| 373H00000X Day Training/Habilitation Specialist | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2026-03-30 |