| NPI | 1134007396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: NC 480257) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: NC 480257) |
| Enumeration Date | 2025-08-25 |
| Last Update Date | 2025-08-27 |