| NPI | 1023709722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 172A00000X Driver |
| 3747A0650X Technician, Attendant Care Provider | |
| 376J00000X Homemaker | |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2023-05-15 |