| NPI | 1033813076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251X00000X Supports Brokerage |
| Additional Taxonomies | 3747P1801X Technician Personal Care Attendant |
| 376J00000X Homemaker | |
| 172A00000X Driver | |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2023-03-27 |