| NPI | 1568825081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist (Licence: CO 85621552) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: CO 85621552) |
| 376J00000X Homemaker (Licence: CO 85621552) | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2016-04-01 |