| NPI | 1003510439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker (Licence: PA 68953601) |
| Additional Taxonomies | 385H00000X Respite Care (Licence: PA 68953601) |
| 376K00000X Nurse's Aide (Licence: PA 68953601) | |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2023-03-29 |