| NPI | 1851026116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 376G00000X Nursing Home Administrator |
| Enumeration Date | 2022-07-20 |
| Last Update Date | 2022-07-20 |