| NPI | 1952803645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 385H00000X Respite Care | |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2018-03-08 |