NPI | 1558002451 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
Additional Taxonomies | 133VN1301X Dietitian, Registered, Nutrition, Oncology |
3747A0650X Technician, Attendant Care Provider | |
3747P1801X Technician, Personal Care Attendant | |
Enumeration Date | 2022-04-05 |
Last Update Date | 2022-04-14 |