| NPI | 1104622778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 372500000X Chore Provider |
| 376J00000X Homemaker | |
| Enumeration Date | 2025-02-24 |
| Last Update Date | 2025-12-11 |