| NPI | 1730940479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 372600000X Adult Companion |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2024-01-19 |
| Last Update Date | 2024-01-19 |