| NPI | 1720534472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2022-12-06 |