| NPI | 1538510292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist |
| 372600000X Adult Companion | |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2025-06-18 |