| NPI | 1902587892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: OH RK610548) |
| 347C00000X Private Vehicle (Licence: OH RK610548) | |
| 372600000X Adult Companion | |
| Enumeration Date | 2023-07-25 |
| Last Update Date | 2023-07-26 |