| NPI | 1134962731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based |
| 374U00000X Home Health Aide | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities (Licence: MI A530792815197) | |
| 385HR2065X Respite Care Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-06-18 |