| NPI | 1063718864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: FL 188926) |
| Additional Taxonomies | 372500000X Chore Provider (Licence: FL 188926) |
| 372600000X Adult Companion (Licence: FL 188926) | |
| 373H00000X Day Training/Habilitation Specialist (Licence: FL 188926) | |
| 376J00000X Homemaker (Licence: FL 188926) | |
| 376K00000X Nurse's Aide (Licence: FL 188926) | |
| Enumeration Date | 2011-01-27 |
| Last Update Date | 2011-01-27 |