| NPI | 1780485243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist (Licence: NE 93650030) |
| Additional Taxonomies | 372600000X Adult Companion (Licence: NE 93650030) |
| Enumeration Date | 2025-03-21 |
| Last Update Date | 2025-04-08 |