| NPI | 1003462953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 372600000X Adult Companion |
| 3747P1801X Technician, Personal Care Attendant | |
| 374U00000X Home Health Aide | |
| 385H00000X Respite Care | |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2019-08-21 |