| NPI | 1932607389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2018-01-30 |