| NPI | 1841994159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 376J00000X Homemaker | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2023-03-29 |