| NPI | 1104702760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 372600000X Adult Companion |
| 374U00000X Home Health Aide | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2025-08-11 |
| Last Update Date | 2025-08-13 |