| NPI | 1922931385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 372500000X Chore Provider |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2026-06-05 |
| Last Update Date | 2026-06-05 |