| NPI | 1558169938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 374U00000X Home Health Aide |
| Enumeration Date | 2025-03-03 |
| Last Update Date | 2025-05-22 |