| NPI | 1871856443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) |
| 251F00000X Home Infusion | |
| 251K00000X Public Health or Welfare | |
| 251S00000X | |
| 251V00000X Voluntary or Charitable | |
| 253J00000X Foster Care Agency | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2012-06-19 |