| NPI | 1780499301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 372600000X Adult Companion |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2025-02-11 |
| Last Update Date | 2025-03-13 |