| NPI | 1912193897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 8464) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2025-02-28 |