| NPI | 1598642555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist |
| 374700000X Technician | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2025-08-20 |
| Last Update Date | 2025-08-20 |