| NPI | 1841018843 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 222Q00000X Developmental Therapist | 
| Additional Taxonomies | 103K00000X Behavior Analyst | 
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2024-09-30 | 
| Last Update Date | 2024-09-30 |