| NPI | 1063940393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 171WH0202X Contractor, Home Modifications |
| 225C00000X Rehabilitation Counselor | |
| 253Z00000X In Home Supportive Care | |
| 347C00000X Private Vehicle | |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2022-07-21 |