| NPI | 1841018843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 374U00000X Home Health Aide |
| 376J00000X Homemaker | |
| 376K00000X Nurse's Aide | |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2026-04-28 |