| NPI | 1104714351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 372600000X Adult Companion |
| 3747P1801X Technician, Personal Care Attendant | |
| 372500000X Chore Provider | |
| Enumeration Date | 2025-06-26 |
| Last Update Date | 2026-01-05 |