| NPI | 1104713411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| 376J00000X Homemaker | |
| Enumeration Date | 2025-06-19 |
| Last Update Date | 2025-06-19 |