| NPI | 1831575315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 10061) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 372600000X Adult Companion | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2025-12-12 |