| NPI | 1982597399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 172A00000X Driver |
| 372600000X Adult Companion | |
| 106S00000X Behavior Technician | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2025-06-03 |
| Last Update Date | 2025-06-03 |