| NPI | 1053115949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 372500000X Chore Provider |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2025-04-01 |
| Last Update Date | 2025-04-01 |