| NPI | 1063256188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 372600000X Adult Companion |
| 3747P1801X Technician Personal Care Attendant | |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2025-05-22 |