| NPI | 1134082019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| 376J00000X Homemaker | |
| Enumeration Date | 2025-12-08 |
| Last Update Date | 2025-12-08 |