| NPI | 1548069602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 372600000X Adult Companion |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2025-03-11 |
| Last Update Date | 2026-02-04 |