| NPI | 1023980992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 372500000X Chore Provider |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2025-09-20 |
| Last Update Date | 2026-03-12 |