| NPI | 1912786351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 372600000X Adult Companion |
| 172V00000X Community Health Worker | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2026-06-08 |