| NPI | 1629761549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 172V00000X Community Health Worker | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 374700000X Technician | |
| 3747P1801X Technician, Personal Care Attendant | |
| 385H00000X Respite Care | |
| Enumeration Date | 2023-05-26 |
| Last Update Date | 2025-08-29 |