| NPI | 1043171234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 174200000X Meals |
| 251E00000X Home Health | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2025-11-19 |
| Last Update Date | 2025-11-30 |