| NPI | 1134966427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: IN 240173741) |
| Additional Taxonomies | 251E00000X Home Health (Licence: IN 240173741) |
| 3747A0650X Technician, Attendant Care Provider | |
| Enumeration Date | 2024-07-12 |
| Last Update Date | 2024-12-12 |