| NPI | 1881589950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202D00000X Integrative Medicine (Licence: VA AIHM) |
| Additional Taxonomies | 251E00000X Home Health |
| 253Z00000X In Home Supportive Care | |
| 374U00000X Home Health Aide | |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| 101Y00000X Counselor | |
| 376J00000X Homemaker | |
| 372600000X Adult Companion | |
| 225C00000X Rehabilitation Counselor | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2025-06-10 |
| Last Update Date | 2025-10-15 |