| NPI | 1588459259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 133N00000X Nutritionist | |
| 136A00000X Dietetic Technician, Registered | |
| 172A00000X Driver | |
| 3747A0650X Technician, Attendant Care Provider | |
| 3747P1801X Technician, Personal Care Attendant | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2025-04-11 |
| Last Update Date | 2025-04-11 |