| NPI | 1811160369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 3747A0650X Technician Attendant Care Provider |
| 3747P1801X Technician Personal Care Attendant | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2008-04-07 |